Use of biomarkers in pediatric sepsis: literature review

Abstract

Despite advances in recent years, sepsis is still a leading cause of hospitalization and mortality in infants and children. The presence of biomarkers during the response to an infectious insult makes it possible to use such biomarkers in screening, diagnosis, prognosis (risk stratification), monitoring of therapeutic response, and rational use of antibiotics (for example, the determination of adequate treatment length). Studies of biomarkers in sepsis in children are still relatively scarce. This review addresses the use of biomarkers in sepsis in pediatric patients with emphasis on C-reactive protein, procalcitonin, interleukins 6, 8, and 18, human neutrophil gelatinase, and proadrenomedullin. Assessment of these biomarkers may be useful in the management of pediatric sepsis.

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

“…current knowledge of PCT levels to predict blood culture results is scarce, especially in children (12)(13). A 2015 meta-analysis showed that PCT is highly accurate in differentiating bacterial and viral meningitis in children with 96% sensitivity (12). In our study included 311 consecutive patients, over a 7-year study period, PCT was effective to predict blood-culture results in cases that underwent a sepsis episode, particularly in immunocompromised children.…”

“…Although PCT as a biomarker for sepsis has been described in previous studies. current knowledge of PCT levels to predict blood culture results is scarce, especially in children (12)(13). A 2015 meta-analysis showed that PCT is highly accurate in differentiating bacterial and viral meningitis in children with 96% sensitivity (12).…”

Proinflammatory cytokine profile in children with neonatal sepsis

“…Другой провоспалительный цитокин -ИЛ-8 яв-ляется мощным хемоаттрактантом и индуцирует активацию нейтрофилов [9,18]. На высокую диа-гностическую ценность повышенных величин ИЛ-6 и ИЛ-8 указывается в проведенных метаанализах по оценке роли этих цитокинов в диагностике неона-тального сепсиса [19,20]: высокие значения уровня ИЛ-8 ассоциируются с рисками развития не толь-ко самого сепсиса, но и в целом неблагоприятного исхода заболевания [21].…”

Sepsis in Children

“…Since the clinical signs of sepsis in neonates are very subtle and nonspecific, predictive biomarkers are needed, particularly in economically developing countries, where the incidence, morbidity, and mortality of early neonatal sepsis (ENS) (sepsis diagnosed less than 72 h after birth) are particularly high. Evidence published to date is still far from convincing the physician to use procalcitonin as a biomarker for routine use in clinical practice as a risk stratifier and a prognostic predictor or even to guide the duration of antibiotic treatment and bedside decision making [23]. The results of a new study by He et al indicate that elevated IL-27 strongly correlates with ENS and may provide additional diagnostic value along with procalcitonin [24].…”